Colorado’s Long-Term Care Ombudsman Program

1. Colorado’s Long-Term Care Ombudsman Program Comments From

2. Older Americans ActOlder Americans Act (OAA), Title VII, Chapter 2, Sections 711/712 • The OAA requires Ombudsman programs across America to: • Identify, investigate, and resolve complaints made by or on behalf of residents; • Provide information to residents about Long Term Supports and Services; • Ensure that residents have regular and timely access to ombudsman services; • Represent the interests of residents before governmental agencies and seek administrative, legal, and other remedies to protect residents; and • Analyze, comment on, and recommend changes in laws and regulations pertaining to the health, safety, welfare, and rights of residents.

3. 2018 Colorado State Long-Term Care Ombudsman Program Brief (Part One) • In Fiscal Year 2017/18, across Colorado, local ombudsmen: • Investigated 3,787 complaints of which 2,868 were partially or fully resolved to the satisfaction of the resident. • Provided 6,583 consultations to staff or administrators of facilities and 10,434 consultations to residents, their family or friends or to the community at large on a wide range of long-term care issues and concerns. • Attended 1,506 resident council meetings and conducted 167 community education sessions and 112 training sessions for people who work in long- term care settings.

4. 2018 Colorado State Long-Term Care Ombudsman Program Brief (Part 2) • 1. Resident Care | includes medical, personal and therapeutic services such as counseling [1,030] • 2. Quality of Life | includes resident conflict, diet and environmental complaints [710] • 3. Autonomy, Choice and Respect of Rights | includes honoring choice and preference for care and care providers, being treated with dignity [556] • 4. Admission, Discharge, Eviction | includes involuntary discharge, room changes, admission contracts [362] • 5. Other Resident Rights | includes abuse, neglect, right to visitors and information [327]

5. State PACE Ombudsman Program(An Integral Part of the CSLTCOP) PACE is a Medicare/Medicaid Program (Managed care model, Addresses both health and social determinants of health) Formed in 2016 as a result of the privatization of Innovage. In the first two years… • The PACE Ombudsman Program worked on 300 cases, completed 165 visits to PACE centers or people's homes, and provided outreach to 1,030 people. • Top Three Concerns Addressed by PACE Ombudsman • Lack of Timely Response for Acute Symptom Management • Lack of Person-Centered Response Across All PACE disciplines • Staff Attitude

6. Now…you be the Ombudsman!

7. Neil Milner says… An ombudsman has an obligation when it spots trouble, when it spots patterns, basically to speak truth to power.

8. Dear Ombudsman… • My Dad began drinking when he was 8 years old. He worked for the railroad, and he retired after 40 years with a watch and a commendation from his Chief. He was drunk every day he worked and every day of his life, as I knew him. • Despite that, he loved my mother, he earned a regular paycheck and gave us a home. His work allowed me to go to college. • Now, in his nursing home, he is only allowed a drink a day. I know he has dementia, and I know likely alcohol has brought it early. • But he wants more than one drink a day – how can we help him with what he wants for happiness?

9. Dear Ombudsman.. • My family is Japanese. My father was taken out of an interment camp as an 18 year old and essentially drafted to fly air missions, AGAINST JAPAN, where our relatives live. • He is now demented and can be combative. The nursing home says they cannot continue to have him there – but he fought for this country and he cannot help this behavior. • The doctor did not return calls at first. But now he offering medication and seems engaged. • But he will not stand up to the Administrator, who wants to discharge my father.

10. Dear Ombudsman.. • I am a CNA. One of the doctors just told a resident they should “Buck Up” to the pain of her arthritis. • She is a sweet woman and would not complain, but I have seen her crying from the pain. • This was before she was made to go through pain medicine reduction. • No one is talking to her about how to “Buck Up” and I don’t have training/time/confidence to help her. • But now she is both hurting and scared – what do I do?

11. Dear Ombudsman.. • My mom has herpes. She would never tell me this, but her husband (not my dad) is concerned. • (This was a VERY DIFFICULT conversation for the two of them) • She cannot communicate her pain effectively, but the doctor won’t give her prophylaxis. • Her husband worries that she will be hurting and have no assessment or medicine to help. • Is anyone really looking at my mom’s vulva and anus to be sure she is not in an exacerbation?

12. Who Are The Heroes In This?

13. I Know a Doctor Who… • Came to a home three times in a day to train every shift on how to support someone living with a severe personality disorder • Met with a belligerent family and brokered an agreement for how to work alongside staff in gaining the goals of care • Trained a staff to talk with residents and families about CAUTI • Wrote a letter to the court about a resident who is regaining competence after a TBI and may no longer need a guardian • When a resident to resident (critical) abuse incident happened, called the family that same evening to discuss next steps and offer help to avoid a discharge. • Came up to a resident who was listening to a performer and said…

14. And the Other Heroes are…

15. For All You Do, I Thank You! Anne Meier Bettye’s Daughter Anna Seale’s Granddaughter Mabel’s Granddaughter

16. Anne K. Meier Colorado State Long Term Care Ombudsman Disability Law Colorado 455 Sherman, Suite 130 Denver CO 80203 303 722-0300 ameier@disabilitylawco.org